CARING FOR THE DYING

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1 CARING FOR THE DYING A COLLECTION OF ADVICE FOR FPMT HOSPICE SERVICES FROM LAMA ZOPA RINPOCHE The purpose of being born as a human being is to eliminate the suffering of others and to bring them happiness. Lama Thubten Zopa Rinpoche December

2 Contents Introduction 3 His Holiness the Dalai Lama on Hospice Service 4 Cultivating Helpers Minds 5 Helping the Sick and Dying 13 Buddhist Euthanasia and Compassion 23 The Time of Death 25 After Death 29 Consecrating Ashes into Stupas or Statues 33 Supporting Helpers 37 List of FPMT Hospice Services 38 Practice Materials for Helping the Dying and Those Who Have Died 39 About Lama Zopa Rinpoche and the FPMT 40 Sources of the Advice contained in this Booklet 41 2

3 Introduction Hospice work should be based on three principles: 1. It is inevitable to die. 2. Every minute so many sentient beings die, so we are not so special (or so alone) dying. 3. It is very important to die with bodhichitta in the mind. The purpose of our life is not just to solve our own problems, to obtain happiness for ourselves. This is because all of our happiness, our comfort, everything we enjoy in our everyday life, we receive by the kindness of others. Our survival is dependent on the kindness of other beings. So the ultimate goal or purpose of our life is to free all other beings from their problems and to bring them happiness. It is highly meritorious to offer hospice service as it is an immediate service to the community. He also advised for us to integrate Dharma into our hospice work because ordinary social work (whilst beneficial) is concerned with this life only whereas Dharma deals with all future lives. During an illness, the main thing is to take care of the dying person s mind. Many others can take care of the body, but we can take care of the mind. In modern culture, there are a lot of questions about death and rebirth because there is a lack of clarity or education about these two things. Among psychologists and doctors, there are many different points of view about these, which indicate that there is a lot to learn about what the mind is. It is only by understanding what the mind is that one can understand what death and rebirth are and what is the best method to help a dying person. The needs of a person who is experiencing death, who is at this crucial point in life, are unbelievable, and they need support. People commonly find this experience terrifying, but for those who have lived a positive life a life of being sincere, good hearted, loving and compassionate towards others death is not something to be afraid of but is actually something to be enjoyed. Such people can die peacefully, happily, and confidently, without fear, worry, or doubt, knowing that they are going to a better place where they can be of more benefit for mankind, for other living beings. For these people death becomes a path for peace, whereby in the life after this they can achieve or experience greater success and happiness. Those who have maintained a positive mental state, free from negative emotions such as attachment towards one s own body, belongings, the people around them, death is like this. Death is just like taking off an old dress and putting on a new one. We just leave our old body and take another new, healthy, young body. Then by developing our mind again (in the next life) we are able to be of more benefit to others. But for most people, when death is approaching they find it the hardest and most difficult time in their life. So therefore, this is the time that they really need some refuge or support. 3

4 HIS HOLINESS THE DALAI LAMA GIVES HIS BLESSINGS TO A NEW FPMT HOSPICE SERVICE Jamyang Buddhist Center in London, UK recently started a new project called Tara Hospice Service, and asked His Holiness the Dalai Lama for a statement of support. His Holiness very quickly wrote a letter of support. (December 2002) Rinpoche was very very happy reading this letter, and said it is very important for relevant centers to frame the letter and have it on the wall to inspire others - Rinpoche said this is very very good to do. From His Holiness the Dalai Lama: Illness, suffering and death are part of the reality of human existence. It would be as foolish to pretend that we are not sick when we are, or that we will never die, as it would be to deny the possibility of ever getting well. As living beings, we all wish for happiness and seek to avoid suffering. However, our basic attitude towards suffering makes a great difference to the way in which we experience it. An important factor in dealing with serious illness, whether we ourselves are sick or caring for someone who is, is to train the mind. On one level this means cultivating a sincere compassionate motivation and performing positive actions serving other sentient beings. At another level it means calming and controlling the mind, which is a more profound way of preparing for the future. Identifying negative states of mind like anger, hatred, frustration, jealousy and pride, we can work to eliminate them. At the same time we can cultivate positive attitudes like compassion and love, tolerance and contentment. Training the mind in this way is both useful and realistic. Love and kindness are not a luxury, but a source of health and happiness for others and ourselves. Real care of the sick does not begin with costly procedures, but with the simple gift of affection and love. In the practice of healing, a kind heart is as valuable as medical training, because it is the source of happiness for both oneself and others. People respond to kindness even when medicine is ineffective, and in turn cultivating a kind heart is a cause of our own good health. I am happy to learn that a project to set up a Buddhist Hospice had been launched in conjunction with the Jamyang Buddhist Centre in London. Helping others wherever you can according to their need is the true expression of compassion and I am always encouraged when people take practical steps like this to put such positive motivation in action. NB: FPMT Hospice Services who would like a copy of this letter on His Holiness' letterhead should contact Center Services at International Office. 4

5 Cultivating Helpers Minds Understanding the reasons for helping There is actually a reason that we need to help others. It is a clean-clear pure reason: it is simply that a sentient being is suffering and needs our help. If a blind person is in danger of falling down a cliff because they cannot see, and you have eyes to see that person s life is in danger and arms to hold them, it does not matter if that person does not ask you to help them. Your help does not depend on their asking you for it. Just having the capacity to help is itself enough reason for us to run to that person and grab them before they fall down the cliff. We have the same need to help other sentient beings and it does not depend on them asking for our help. We should help them simply because we have the capacity, or potential, to help them now. And even if we do not have the capacity to help them now, we can develop it by increasing our compassion and wisdom. The more compassion and wisdom we are able to develop, the more it develops our potential to help others, the greater the power we will have to liberate others from all suffering and its cause, which is within them, on their mental continuum. The cause of their suffering is their karma and delusions, their mistaken ways of thinking, and the negative imprints left by them on their mental continuum. Karma is related to oneself. Therefore one has to pay attention by helping another person cut down his negative karma. That would be the most practical thing to do to help with the dying because at the time of death, negative karma should be lessened or weaker. You get skies of benefit when you help others sincerely from your heart, by knowing that the meaning of your being born as a human being at this time is to serve others. When we serve others with this knowledge and with compassion, our everyday life brings us so much peace, happiness, and satisfaction. Then our inner life is full rather than empty. Developing the benefits for our future lives and for the ultimate goal of enlightenment As far as the karmic results of the work we are doing, serving sick and dying people, there are eight ripening results. Because karma is expandable, we can experience the result of one good karma many times in one life and in many lifetimes in hundreds or even thousands of lifetimes. So, the one good karma of serving others, making charity, can result in wealth in hundreds or thousands of lifetimes. Some of the eight ripening results are: (1) In all coming future lives when we are born as a human being, we will have a long life. (2) We are making charity to others, and this will also become a cause of wealth, both in this life and especially in future lives. (3) If we are humble and respectful of those whom we serve, we will be respected by others or achieve power in this life and in future lives. We can bring so much peace and happiness to millions of sentient beings. Consider His Holiness the Dalai Lama, for example. His Holiness brings peace and joy to everybody who sees him. Seeing His Holiness even once is 5

6 an unforgettable experience. Just seeing his smile or hearing his voice brings so much peace. By having such power, we can benefit millions of people. (4) We will also have a perfect body, wisdom, and be born in a high caste. This is referring specifically to being reborn in countries in the East. In many countries in the East, if we wish to benefit others, we need to be born in a high caste so that everyone respects us. We can then benefit so many sentient beings, although there are cases to the contrary such as the great Tibetan yogi Milarepa. Milarepa was only one of countless meditators who became enlightened in one brief lifetime of this degenerate time and Milarepa is the yogi who is best known in the West. Somehow, perhaps owing to his bodhichitta, Milarepa s name became very famous, even though many other Tibetan lamas and meditators also achieved enlightenment in one lifetime. Milarepa had nothing not even one dollar. But his mind and his body were very powerful. He lived in the mountains, where he meditated and achieved enlightenment. He was able to endure hardships, and he was then able to conquer all his ignorance, anger, attachment and other delusions and to cease even their negative imprints. He was able to achieve full enlightenment. Because he had a powerful body and mind, Milarepa could achieve enlightenment very quickly. In a similar way we are also performing a difficult service that many other people cannot perform. By taking upon ourselves the responsibility to do such difficult things, we create the cause to have a powerful body and mind in our future lives, so that we will be able to complete the realizations and achieve enlightenment. In our future lives we will again be able to bring incredible skies of benefit to other sentient beings. The other four of the eight ripening aspect results are explained very clearly in the lam-rim texts. The importance of cultivating a good heart The most important characteristic for a volunteer/helper is to have a good heart. It does not matter if the caregiver is Buddhist or Christian as long as he or she has a good heart. When we say having a good heart, we mean having an awareness of the purpose of one s own life: My job, the reason I m here, the reason I have this precious human body, the purpose of my survival is to bring happiness to others. Any being that we see, try to feel this, try to generate this thought. It is extremely good, very important to practice Dharma, the good heart, and this is the best psychology to stop depression, to stop the unhappy mind. By changing your attitude, instead of thinking of only oneself, think of others daily. With this, life becomes very joyful, very pleasant, very heart-fulfilling. So even if there are problems or sickness in this life, by living with this attitude in our daily life, with this awareness, they cannot bother us. Our attitude is thinking about others, a complete switch. There is no emotional mind, no anger arising or retaliation or jealous mind. The importance of learning the Dharma There are different levels of how to be useful to other sentient beings, to help them achieve (1) temporary happiness causing happiness in this life or future lives, and (2) ultimate happiness 6

7 bringing others out of samsara, ceasing their suffering, then bringing them to the highest enlightenment. Those who have good heart but no understanding of Dharma the path to liberation and enlightenment who attempt so sincerely in spite of their lack of dharma wisdom knowledge, can still be useful to others, but only by causing happiness in this life, nothing more than that. Without an understanding of Dharma, what they can do is limited. Therefore, to learn Dharma becomes extremely important. Why? The purpose is to actualize the meaning of the words, to have the meaning of Dharma, the meaning of the words in our heart. Our heart is transformed into the meaning of the teachings. So one is able to subdue one s own mind. The mind becomes softer, more patient, more tolerant, more compassionate, more loving to others, also kinder to others. These very basic qualities of the human mind give value to human life, make this human body meaningful, worthwhile. The importance of preparing for our own death, future lives, and ultimate enlightenment Helping to look after people who are sick and dying is itself the best preparation for our own death. Fear of death does not come from outside, but from within our own mind, because of our delusions and negative karma. Fear is the result of attachment and other negative emotional thoughts and of the negative karma collected in the past. By serving others with a sincere mind in our everyday life, we purify so much of those negative karmas and develop a good heart. Serving others with a sincere heart brings us peace and satisfaction every day. We feel happy, and we see our life as meaningful. It fills our life with happiness and fulfillment now and also ensures that we have the best future. Creating so much merit is also the best preparation for our own death. It will ensure that we have a peaceful, happy death, with no anxiety or frightening karmic appearances. Our consciousness will then have a good journey to the next life, so this will result in a good rebirth. Like changing our clothes, we will leave this old body and take a new one in the pure land of Buddha or take another perfect human body. What we are doing creates so many causes to achieve a powerful perfect human body with the eight ripening qualities. Lama Tsongkhapa explained that it is by having such a body that we can really achieve realizations of the path to enlightenment. Since what we are doing here is creating so many causes for such a body, it is something about which we should rejoice. We will receive incredible benefit now at the time of our death, and in all our future lives up to enlightenment. The ultimate benefit will be that after we achieve enlightenment we will be able to liberate numberless sentient beings from all their suffering and bring them to enlightenment. Even without any expectation of receiving benefits by serving others, we will naturally achieve all these results. In other words, serving others is the project for future lives. We cannot be sure about our plans for this life. Everything is uncertain; whether we can finish what we are doing or what our lives will be. We cannot put our signature to the fact that we will be alive tomorrow, that we will definitely be able to complete our works. What is definite to happen is death. The time when death will occur is very uncertain. It can happen any time, any day, any hour, any minute. So as Lama Tsongkhapa mentioned, for the time being, until one reaches a certain level of the path, one cannot stop death. 7

8 Even plans such as helping others, sincerely benefiting others, or liberating one s own mind from delusions, no matter how big our projects are, if they are not for Dharma, if they are just for the happiness of this life, then they are nothing. They are just like other big non-virtuous projects. So our project or work for future lives happiness is to stop, to cease, the causes of the bad migrations. That means two things: first, to purify the negative karma already created in this life and past lives. And second, to create the causes for higher rebirth, for liberation from samsara, the definite goodness, and for the ultimate happiness up to enlightenment, which means the happiness of all future lives. We must immediately start this work for happiness, for obtaining happiness beyond this life up to enlightenment. So then we are well prepared even before death comes. The work for all future happiness is done. The importance of daily practice and prayers His Holiness the Dalai Lama says that it is difficult at the time of death to really meditate as we did in life. If during our life we could not meditate well, then we will not be able to meditate at death; we will not be able to hold our concentration. Meditating on the lam-rim is one of the best preparations for death. One should do those specific practices that are explained in the lam-rim, in the teachings of the stages of the path to enlightenment, those preliminary purification practices of making offerings to the guru Triple Gem, doing prostrations, or recitation of mantra. These transform the mind into the path to the enlightened state, or the three principles of the path to enlightenment, and the tantric paths, the two stages. The lam-rim explains the four ways to accumulate powerful, extensive merit. One can also do meditation on the Four Noble Truths, the very fundamental Buddhadharma, to achieve liberation from samsara. One very important meditation is on suffering, impermanence and death. This is extremely easy to meditate on and extremely powerful to cut the delusions our true enemies. It is also important to integrate the five powers* into our life and to learn the five powers to be practiced at death. These are very special practices to achieve enlightenment quickly. They involve powa, the transference of consciousness at the time of death into a pure land. In the pure land one receives teachings on the Vajrayana, which enable one to achieve enlightenment in one lifetime. The effectiveness of powa depends on how well one practices the five powers at death (determination, white seed, repudiation, prayer, familiarity). And this depends on how well one does the general practices in life. Besides that, in our daily life we should keep the mind as much as possible in the good heart, the thought of benefiting others, keeping it alive twenty-four hours a day, keeping the mind in the attitude of the good heart. So generate the thought, remember that the purpose of one s own life is to free every living being from all the sufferings and to cause the happiness of all numberless beings. It is extremely good to practice mindfulness of the meaning of life in our daily lives. That means to have the constant awareness everywhere in the office, at home, on the street, that I m here to bring happiness to others. And likewise with animals we think like this: I m here to bring happiness to these insects, to these animals, to these fish, to this people. 8

9 Practicing the good heart, that is, bodhichitta, during your life purifies so much negative karma, including very heavy karma, and it stops one from creating more. It is negative karma that makes the mind experience fear of death. And it is bodhichitta especially that stops the immeasurable suffering and the suffering rebirths that arise later from these negative actions. Therefore, we should live in morality and take the precepts from a spiritual master or in front of holy objects. It is good to dedicate the merit in the following way in the morning after our meditation practice and especially at the end of the day, when we dedicate the merit from whatever good actions we have done that day. Due to all the past, present, and future merits collected by me and the merits of the three times collected by all the buddhas, bodhisattvas, and other sentient beings, may any sentient being just by seeing me, touching me, talking about me, remembering me, or dreaming about me never ever be reborn in the lower realms from that time forward. May they immediately be liberated from all disease, spirit harms, negative karma, and defilements. Talking about me can refer to praise or criticism even someone making fun of us. Seeing me can include seeing our photo. We pray that any connection with us prevents that being s rebirth in the lower realms the hell, hungry ghost, or animal realms. Also make the following strong prayer: May anyone who sees me, touches me, talks about me, or remembers me immediately be cured of cancer, AIDS, coma, arthritis, migraine, and other heavy diseases. May those possessed by spirits be immediately released from the harm of those spirits. May anyone who is dying immediately stop experiencing terrifying emotions and karmic appearances and feel incredible bliss in their heart. May they then be born in a pure land of Buddha, where there is no suffering of rebirth, old age, sickness, or emotional problems. Totally free from all suffering and its causes, may they become enlightened there. If we generate such a thought to benefit others every day, we become meaningful to behold. This means that everything about us becomes healing: hearing our voice, seeing us, touching us, remembering us. The sutra teachings mention that all dharmas** exist in dependence upon the wish. Whether harmful or beneficial, phenomena are actualized from our intention, our wish. All happiness comes from our wish, from our positive intention. Enlightenment, total liberation from samsara, is a creation of mind; it comes from our wish. All phenomena exist in dependence upon the wish. (**Here, the term dharmas simply means phenomena.) Thus, so much can happen from the power of our mind generating such a wish, by praying in this way. That is the benefit of prayer. Prayer can grant wishes due to the power of mind. The power of prayers can also be seen from how negative prayers to harm others can also be actualized. Wrong prayers can harm many people and even destroy the world. Kirti Tsenshab 9

10 Rinpoche, a guru from whom I have received many initiations, is a great yogi and scholar with limitless skies of qualities and realizations, yet who is extremely humble with respect for everybody, rich or poor, young or old. Rinpoche explained that the destruction of the temples and monasteries (in Tibet) came about in the following way. A long time ago in a Buddhist monastery there was a monk who was naughty and didn t follow the monastic rules. The disciplinary monk scolded him very heavily, and possibly beat him. The monk who was disciplined got very angry and made many negative prayers wishing to destroy monasteries. Rinpoche explained that the problem started from there. Later, I think perhaps in his next life, he destroyed many, many monasteries. So it is important to generate beneficial thoughts, thoughts of benefiting others, and to have faith and trust in the power of prayers. Understanding the cycle of death and rebirth It was explained by the kind and compassionate omniscient Guru Shakyamuni Buddha that even though this body disintegrates (at death), there is still a continuation of consciousness. In the Mahayana (great vehicle) path there are five levels or stages to achieve full enlightenment: the path of merit or accumulation, the path of preparation, the path of seeing, the path of meditation, and the path of no more learning. Until a person achieves the third of these bodhisattva paths, the path of right seeing (wisdom directly perceiving emptiness), that person will have to keep experiencing the cycle of death and rebirth, including old age and sickness, etc. In relation to us, this means that until we achieve this level or path, we will have to keep experiencing this cycle of death and rebirth, and so on. In the highest yoga tantra system of Buddhism, there are two stages: the generation stage and the completion stage. The completion stage itself has five stages: isolation of body, isolation of speech, clear light, the illusory body, and the unification of the clear light and illusory body. When a tantric practitioner achieves the clear light stage, he/she has complete control over death and rebirth. Even in the Hinayana path, one has to experience the cycle of death and rebirth until its cause is stopped. So until we achieve one of these levels or stages that gives us control over death and rebirth, we have to go through the cycle of death and rebirth. The kind of rebirth that we will take after this life, after death, is dependent on the nearest cause, the state of mind at the time of death. Whether the state of mind at the time of death is peaceful or disturbed determines whether one will have a happy or suffering type of mind. It is crucial because it is this that determines the next life s (situation) and the person s long-term happiness. If one is able to achieve a fortunate rebirth, one will have more opportunity to develop the mind and be able to be of more benefit to others. So in this way, from life to life one can develop the mind more and more and in this way experience more and more happiness until one ultimately achieves fall enlightenment. By eradicating all mistakes from the mind and completing all positive qualities (realizations), in particular, complete and perfect wisdom, perfect compassion, and perfect power, one will be able to free everyone from all their sufferings and to bring them the perfect happiness of full enlightenment. One gains the power to understand all the different qualities of the minds of others and to reveal to them the means of eradicating suffering and developing happiness. 10

11 So much of this is dependent on one s state of mind before death, so by understanding this we can see now that our service is unbelievably important and crucial, the best gift. This is what we are offering people through our compassion and wisdom. This is what makes our life meaningful, satisfying, and enjoyable, because what we are offering them is the chance to enjoy happiness from life to life right up to full enlightenment, and this is the best and most important gift. In addition to cultivating our minds, the most important is our own practice. When one does one s own practice, then other people start to feel your mind. They can feel the vibration of your mind warm, good hearted, generous, sincere. And that makes other people respect you, listen to you, want to follow you to practice. Even if one does not practice Dharma, just to be around is very beneficial for other people and for their problems and mind. It brings happiness and peace to their mind. One becomes an example for them. The story of Asanga: a powerful story of compassion and sacrifice I would like to mention the story of the pandit Asanga. Those of you who have heard Dharma teachings will know this story very well. Asanga did retreat in a hermitage for twelve years trying to achieve Maitreya Buddha. After a few initial years of retreat, when he hadn t seen Maitreya Buddha, he left the hermitage. As he came down the road he saw a bird flying into its nest inside a hole in a rock. Asanga saw that the rock had been worn down by the wings of the bird touching it as it went in and out. Even though the bird s feathers were very soft and the rock was very hard, it was still able to wear down the rock. This inspired him, and he thought, If even feathers can wear down a rock, why can t I persevere in my practice to see Maitreya Buddha? So he went back to the hermitage for another three years of retreat. After another three years of meditating, he still had not seen Maitreya Buddha. So he left his retreat again. As he was coming down the road, he saw somebody cutting a rock with a thread. Asanga saw that the rock was being worn through by the movement of the thread. This inspired him again, and he thought, If even a thread can wear through a rock, why can t I persevere in my practice to see Maitreya Buddha? So he returned to the hermitage and did another three years of retreat. Again he didn t see Maitreya Buddha. Once again, Asanga became discouraged and left the hermitage again. Along the way he saw that water dripping onto a rock had made a hole in it. Water is soft and rock is hard, but by dropping continuously the water had made a hole. This again inspired Asanga, and he thought, If even drops of water can make a hole, why can t I persevere in my practice to see Maitreya Buddha? He then went back and again spent another three years in retreat. After twelve years of retreat, he still hadn t seen Maitreya Buddha. He then decided to leave definitively. When he came down from the hermitage, he saw a wounded dog in the road. The dog s lower body was an open wound filled with maggots. Asanga felt unbearable compassion for the dog. He cut some flesh from his calf and spread it out on the ground. He then closed his eyes and went to pick up the maggots from the infected wound with the tip of his tongue. But he found that he could not touch the maggots. When he opened his eyes, he saw in front of him not a dog but Maitreya Buddha. It was Maitreya Buddha all along. There was no wounded dog and no maggots. Before Asanga generated unbearable compassion for the dog and sacrificed himself, thus purifying his mind, he 11

12 had seen just a dog. When his mind was impure and obscured by karmic obscurations, instead of seeing Maitreya Buddha he simply saw a wounded dog crawling with maggots. By generating unbelievable compassion and sacrificing himself to serve that living being, Asanga purified all the defilements that blocked his seeing Maitreya Buddha. His impure karma had projected a pitiful wounded dog covered with maggots. Asanga completely purified all these defilements, and when this impure karma had been purified, he could then see Maitreya Buddha. Asanga immediately grabbed onto Maitreya Buddha and said, I have been meditating for a long time, why didn t I see you earlier? Maitreya Buddha replied, I was there in the hermitage, but you didn t see me. Maitreya Buddha then showed Asanga the marks on his robes from Asanga s spit. Asanga used to spit in his cave, and the spit went on Maitreya Buddha s robes. Maitreya Buddha showed Asanga the marks to prove that he was always in the hermitage it was just that Asanga hadn t been able to see him. Maitreya Buddha then asked Asanga, What do you want? Asanga asked Maitreya to give teachings. Maitreya Buddha then took him to the pure land of Tushita, where in one morning, which is equivalent to fifty human years, Maitreya taught him the entire Abhisamayalamkara, which explains the whole path to enlightenment, the eighth chapter of which talks in detail about the four kayas, or Buddha s holy body and mind. This text is studied for many years in Sera, Ganden, and Drepung, the largest monasteries in Lhasa and now India, and in the branches of those monasteries. All five divisions of Maitreya Buddha s teachings are studied for many years. Aftre receiving these teachings Asanga brought them down to the human world and wrote them down. On the basis of these teachings Lama Atisha wrote Lamp of the Path to Enlightenment and Lama Tsongkhapa then wrote extensive commentaries. Many other enlightened lamas also wrote commentaries. Countless meditators in Tibet actualized the path and became enlightened by studying these teachings and their essence, the lam-rim. Nowadays these great teachings have even spread to the Western world, where every year tens of thousands of people are able to make their lives meaningful by following the path to enlightenment. All this came from the teachings that Maitreya Buddha gave to Asanga. Those teachings are the basis. All these things happened because Asanga generated intense compassion and was willing to sacrifice himself for one living being, a wounded dog. With all these teachings, so many beings inside and outside of Tibet have been able to make their lives beneficial, and many beings have been able to achieve enlightenment. Now we can also receive these teachings, which make our life meaningful. All this came from Asanga s great compassion, his bodhichitta, in sacrificing himself to help what he saw as a wounded dog. All this came from one person offering service to one sentient being, from one person generating compassion for a wounded dog. So, the benefits are unbelievable. All these benefits that we receive came from Asanga s compassion. During his twelve years of retreat nothing happened; it was only after he sacrificed himself to take care of a wounded dog that he was able to see Maitreya Buddha. That is the point I wanted to make. 12

13 Helping the Sick and the Dying During an illness, the main thing is to take care of the dying person s mind. Others can take care of the body, but as helpers you can take care of the mind. I think that being able to help a dying person s mind is even more important than being able to cure diseases such as cancer and AIDS. If you are a healer and you are able to heal many people from diseases such as cancer and AIDS, it is miraculous, unbelievable. Compare that to helping somebody who is dying, who is at the most terrifying point of his or her life. I think that in this case your service is more crucial and important. This is because by offering psychological advice to the dying person, showing how to look at death as positive, it brings a state of peace and happiness to the mind. The religious tradition of the patient depends on their prior practice in daily life. The advice you give them depends on what you have been doing yourself the lam-rim, thought transformation, and so on beyond mere sitting meditation. The most worthwhile thing to do is to inspire the person to think of others with loving kindness and compassion, to wish others to be happy and free from suffering. If a person dies with the thought of benefiting others, their mind is naturally happy, and this makes their death meaningful. It is very important to know a person s mind. You can teach according to their capacity. Check at the time, use your own wisdom, and judge how profound a method to present to them. It would be best if you could give the dying person some idea of the death process according to tantra: the evolution of the dissolution of the elements, the senses, the consciousness, all the way to the subtle consciousness. For a person who has lost their capacity to understand because of coma, dementia, and so forth, there is not much possibility for them to understand. You should aim to help them get at least a precious human rebirth. This should be your aim, not that the person must necessarily believe in karma, for example, but that they die with a positive, happy mind, with loving kindness and compassion. This is our precious gift. Your main aim in taking care of the physical body is so that you can take care of the mind, to transform their state of mind to the positive so that at least the dying person can die without anger, desire, and so forth. Understanding the fear of death When a person actually reaches these states when dying, you should help and guide. It is more difficult to help because it is very difficult for the person to meditate or understand and think at that time and, therefore, difficult to put your advice into practice. This is because there is a mental fear (even for a person without physical problems or pain), worries, a heavy torture, strong karma at the time of death. So even if there is no physical pain, due to karma there is much fear. The fear of separating from one s relatives and friends, separating from one s possessions, leaving all of these things, separating from the body many mental problems arise from such fears. One thinks, I m going to lose all my belongings, my money, my beautiful house and swimming pool, my car, my friends, my children, my parents, on and on. So the fear comes. Why is our 13

14 mind afraid? Why are we afraid to be separated from them? Because we are attached to these things. What makes it difficult is not being able to let go, is having strong and constant attachment. Generally speaking, especially for a person who is not used to practicing renunciation, it is quite difficult to cut clinging. One spends a whole lifetime with the mind habituated and trained and developed in one thing clinging. And in addition, for those close to actual death, there is also pain and illness. So it is very difficult to help when a person has reached that state. It is difficult to explain meditation to that person, to teach them, and it is difficult for that person to practice. Therefore, while the person is alive and while they have the capacity to understand, it is important to practice. During those times, if we are able to help them, then there is a lot of opportunity for them to be able to understand and put our advice into practice. The healthy times are important. On the other hand, for some people it is not easy during their lifetime, but when they start to experience the body collapsing and they feel they are dying, then maybe the mind is a little more open to renunciation at that time. Reciting mantras You can help a person to recite whatever mantras he or she is familiar with from the past: Vajrasattva, Medicine Buddha, Compassion Buddha, or Guru Shakyamuni Buddha. Even if the person can t recite the mantras himself or herself, the caregiver can recite the mantras to purify and leave imprints. If the mantras are recited nicely, like the Chinese do in their temples, it can inspire the sick person and elevate their spirit. It can make them feel that Buddha is the only refuge, that there is nothing else left in the world that is meaningful, and help to free their mind from problems from attachment, anger, and confusion. Mantra helps one to eventually attain a higher rebirth even if one s positive karma is used up. Even if a person does not want to hear mantra, it leaves a positive imprint on the mind, so that sooner or later that person will meet the path and have the ability to practice the teachings, and thus to clear obscurations and attain enlightenment. Even if someone gets angry hearing mantras and dies with an angry mind, it s still better than not hearing any mantras at all and staying peaceful. In this way, step by step, a person s karma will brings them to the Mahayana path and to enlightenment. If one is going to undergo surgery, before having the operation, if possible, the person should listen to tapes of the teachings of His Holiness the Dalai Lama or to tapes of chanted mantras such as OM MANI PADME HUM. When the person is anaesthetized, he or she will then become unconscious with positive thoughts of devotion to Buddha, Dharma, and Sangha. The main point is to try to help the person to have a last thought that is positive, or virtuous. Then even if the operation doesn t succeed, the person has had the most important protection that saves them from the lower realms. In this way, there is no regret. In this way, the most important help and guidance for the person is given. There are many mantras that can be recited. There are several collections of powerful mantras that can be recited that are available from the FPMT Education Department. See the Hope packet within "Practices not Requiring Empowerment" within the FPMT e-shop for a complete collection of practice materials to help the dying and those who have die. if it is an 14

15 emergency situation or if you have no money to purchase this packet then log in to to download these practices for free. Listening to or reading teachings If the person is a Buddhist student, she can listen to tapes of any teacher she has met or with whom she feels a connection, of guru devotion or of the lam-rim. Those who are not Buddhist can still listen to the teachings of His Holiness the Dalai Lama and Lama Yeshe, especially something inspiring on the subject of bodhichitta. This is a very good thing to do. Patients can either read books themselves on certain subjects from Dharma texts or you can read to them. It is also good to read teachings on the qualities of the pure lands, such as Amitabha s pure land. The person will then admire the qualities of pure lands, where there is no suffering and every enjoyment. This is one psychological method that becomes a cause for the person to reincarnate in a pure land rather than having them cling to this life and this world. It switches the object of their mind so they become detached from this life and this world. Helping someone to die with a virtuous thought is more important than being able to help their mind to be equanimous, than protecting them from attachment and anger. Chanting Prayers People can gather and chant prayers together, such as the following list of short prayers: Refuge and bodhichitta The four immeasurables Special bodhichitta motivation Names of the Thirty-five Confession Buddhas Mantras of the five deities normally used in Jangwa puja* that liberate those dying and the dead and that purify living ones and liberate those in the lower realms. The text Giving Breath to the Wretched* has powerful mantras and is a text one can use to help. The seven-limb prayer and short mandala offering *For more information, contact FPMT Education Services Practices There are many practices that can be performed either by the caregiver, if the person is unable to do so or has already died, or by the persons who are themselves dying. Please see the section entitled Available Practice Materials for Helping the Dying and Those Who Have Died, as well as the Hope packet available from FPMT Education Department. For more details regarding all these mantras and practices, please contact FPMT Education Services 15

16 Stupas A stupa is a Buddhist reliquary monument, symbolic of the Buddha s omniscient mind. Stupas usually contain many blessed objects and mantras and have the power to heal and purify When somebody is dying, take a stupa to their place and each day encourage them to hold it as often as possible, or if they are not able to hold it, then put it on their chest or head. Each time the stupa touches them, some of their negative karma is purified. Even if the consciousness has already left the body, it can still be of benefit to touch the body with the stupa. You can leave the stupa with the dying person and instruct the caregivers that when the person dies, to bless them by putting it on their head or their chest. This is also good to do with babies or with people who don t understand. For someone who is dying (even a non-buddhist) you can explain that the stupa is for peace, or for healing or purification. It is also good to have a few stupas on hand for healing or to dispel spirit harms. But if the person is not comfortable with visualizing stupas or other holy objects, then other objects can be used such as crystals or universal healing energy. The person can visualize light rays coming from the stupa/holy object, as follows: First breathe in slowly, then breathe out. As you breathe out, visualize that all your disease, spirit harms, unskillful actions and thoughts, and the imprints left by these on your consciousness are purified. These all come out of your body as black smoke, or pollution, and disappear beyond this earth. Now, as you breathe in, visualize that strong light beams are emitted from the stupa [or whatever object you are visualising], which symbolizes the perfect, pure mind of full enlightenment. This white light illuminates your body, completely purifying you of all disease, spirit harms, unskillful actions and thoughts, and the imprints left on your consciousness. Feel that your whole body is in the nature of white light. You have no suffering or problems at all. Your mind and body are completely free. From the top of your head down to your toes, your entire body is filled with great joy, with great bliss. After experiencing this great bliss, think that your life has been prolonged, and that your positive energy, the cause of your happiness and success, has been increased. All your qualities of wisdom and compassion have also been developed, as well as your understandings of the path. Everything is fully developed within you. Repeat this meditation over and over again. Breathe out and purify; breathe in and receive light and healing from the holy objects. Feel that your whole body is in the nature of light and filled with great joy. Also, a sheet of paper with the ten great mantras written on it can be put on the dying person s body while reciting the dedication prayers at the end of this meditation. This mantra can be found within the booklet "Powerful Practices for The Dying" within the Hope packet. Meditations 1) Taking and Giving Meditation (tong-len) 16

17 Whether one knows or has done the practice of powa, transference of consciousness, or not, the best way to die, as His Holiness [the Dalai Lama] advises, is with the altruistic thought of equalizing and exchanging oneself for others, cherishing other sentient beings. If one is able to die with that thought, then that is the best way to die and one is a self-supporting person. This means that the person is guided by him or herself and doesn t need to rely on somebody else to help. This is the best fundamental practice in order to be born in a pure realm and to save oneself from the lower realms. It is especially important to give advice on how to experience death on behalf of all other countless living beings who are dying, to experience death on behalf of others; how to use the experience of death to free others from death and to obtain happiness for them, especially ultimate everlasting happiness. In this way, the death experience becomes very positive and useful, not terrifying, because it helps to bring peace and happiness within the dying person s mind. Thinking in this way also purifies from the mind all the negative energy and imprints left on the mental continuum by the person s previous negative or mistaken thoughts and actions. These unhealthy mental states are obstacles for present and future happiness, not only temporary but especially ultimate happiness. If the dying person dedicates this experience for others, it will bring the cause of happiness to countless others. I think that this meditation or psychology is the key to transform the death experience into the spiritual path, bringing not only temporary but ultimate peace and happiness for oneself and for others. You can teach the person the meditation of taking and giving (tong-len; taking upon oneself the sufferings of others and giving to others one s own happiness) or loving kindness meditation (metta) according to the capacity of his or her mind. If the person has a more compassionate nature, a brave mind, they will be able to do tong-len, taking and giving. If the person can do tonglen, it s the very best way to die, as it means dying with bodhichitta. His Holiness the Dalai Lama calls this a self-supporting death. For those who don t think others are more important than themselves, wishing others happiness and to be free of suffering is easier. So the stronger your loving kindness and compassion, the stronger is your thought of benefiting others, to that degree problems won t bother you, no matter how serious they become; whatever diseases and so forth you experience in your own life, they will not seem so important. They will not bother you so much. When you have the thought of benefiting others, this good heart, when you have loving kindness and compassion, if there is this attitude, then even if you have these problems, they become enjoyable, instead of upsetting the mind or making the mind depressed and unhappy. Even if you have these problems, they become enjoyable, such as relationship problems when your friend, your companion, husband, or wife leaves you, and so forth. Due to this positive attitude, then your main focus becomes causing happiness for others. Then these problems become enjoyable rather than making you upset, because with this positive attitude, with this good heart, you use these problems, diseases, relationship problems, and so forth for your spiritual development. You experience these problems on behalf of numberless sentient beings who have the same problems or who have the karma to experience the same problems in the future. Therefore, the problems that you have relationship problems, diseases, business failure in your work, losing your job or so forth they become enjoyable just like the sense objects that we enjoy, such as good music for the ear, or beautiful forms for the eye, or delicious food for the taste. 17

18 2) Visualization If one visualizes Buddha in the mind or outside or watches the conventional nature of mind, its clarity, other thoughts such as anger and attachment do not arise. Explain to the person that the nature of their mind, their heart, is completely pure; that the fully enlightened one, Buddha or God, is compassionate to everyone, including them. (Rinpoche advised the Center for Bevidst Liv og Dod to meditate on God and then explain what God is. In doing so, they are actually taking refuge in Buddha. He recommended meditation for sick people and their relatives twice a month.) Help them to think that their loving heart is oneness with God, that the kingdom of God is within. This frees people from guilt and anger, from their negative thoughts. 3) Lam-rim*** To practice meditation with other sentient beings becomes purification and the accumulation of extensive merits. Leading others to practice meditations on the lam-rim and teaching the lam-rim and explaining it are in themselves consultations to help others to solve their problems. ***For more detailed lam-rim texts, please contact FPMT Education Services 4) Powa If the person is skillful at the time of death and able to practice, able to do the practice of powa, that person may be reborn in a pure realm and in that next life be able to attain enlightenment. However, all these things depend on individual karma. If the obstacles, such as degenerated samaya, vows and so on, are not purified, and the obstacles are stronger than the karma to be able to transfer the consciousness, then powa cannot work. In degenerate times, obstacles are often greater than the individual s karma for transference of consciousness, but if the karma to take rebirth in a pure realm is stronger, then things may succeed. So the success of powa and the possibility of attaining a better rebirth are dependent on purifying and abandoning the causes of rebirth in the lower realms (what has already been accumulated and accumulating virtue and the causes for rebirth in the higher realms (of happy migratory beings). In terms of healing, by practicing altruism, cherishing other sentient beings, the practice of powa purifies past negative karmas and also helps to avoid committing negative karma again, which is the cause of sickness. So it becomes a great solution. Then on top of that, if one can take vows or precepts, of whatever number, that is of course excellent. But practicing altruism, cherishing other sentient beings as much as possible, is itself a purification and helps one to avoid creating the causes of disease or any problem again. So to experience the disease on behalf of other sentient beings, one should do the taking and giving practice (tong-len). On the basis of these practices, as an ornament or decoration, those people with life-threatening illnesses should practice powa, the transference of consciousness at the time of death, when the specific signs of death appear. The right time to do powa is when there is freedom, when there is bodhichitta, that is, based on what is beneficial to all sentient beings. It should not be done because of being jealous of somebody or because of some family problem and so forth. It must be done with 18

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